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TPG Health Academy - Monday 19. September 2016
Developing and Implementing a Simulation-based Curriculum in the Modern Healthcare System
INTRO
WHY?
HOW TO?
QUIZ TIME Professor Lars Konge, MD, PHD
[email protected] Faculty of Health Sciences University of Copenhagen
DO WE NEED EVIDENCE?
CAMES Copenhagen Academy for Medical Education and Simulation
INTRO
WHY?
HOW TO?
QUIZ TIME
Copenhagen Academy for Medical Education and Simulation http://vimeo.com/109224706
DO WE NEED EVIDENCE?
VISION You practice before performing procedures on patients
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INTRO
WHY?
HOW TO?
QUIZ TIME
DO WE NEED EVIDENCE?
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Simulation
Certification
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INTRO
WHY?
HOW TO?
QUIZ TIME
DO WE NEED EVIDENCE?
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Danish Society for Medical Education – National Workgroup on Simulation The National Needs Assessment Project • Identify a technical procedure that your group believes physicians should practice before performing the procedure on patients • Discuss how that is done today
FINAL LIST of PROCEDURES IN PULMONARY MEDICINE
1 2 3 4 5 6 7 8 9 10 11
Flexible bronchoscopy Pleuracentese EBUS-TBNA EUS-FNA/EUS-B-FNA NIV Transthoracic biopsy Focused lung ultrasound Chest tube Needle biopsy Focused heart ultrasound Thoracoscopy
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Speciale
I samarbejde med
2015
Lungesygdomme
Paul Frost Clementsen
2016 Forår
Karkirurgi Urologi Radiologi Gynækologi og obstetrik
Jonas Eiberg Rikke Bølling Hansen Kristina Rue Nielsen Jette Led Sørensen
2016 Efterår
Ortopædisk kirurgi Oto-rhino-laryngologi Pædiatri Kardiologi Oftalmologi
Amandus Gustafsson Jacob Melchiors Thomas Balslev Pia Hass Ann Sofia Skou Thomsen
2017 Forår
Kirurgi Thoraxkirurgi Almen medicin Reumatologi Anæstesiologi
Louise Preisler
2017 Efterår
Neurologi Neurokirurgi Onkologi Dermato-venerologi Plastikkirurgi
2018 Forår
Endokrinologi Gastroenterologi og hepatologi Geriatri Hæmatologi Infektionsmedicin Nefrologi
Lene Russell
Answer these items for each procedure 1) “How frequently is the procedure performed in your department per year?” 2) “How many doctors in your department must be able to perform the procedure?” 3) “The procedure is very uncomfortable and/or risky to the patient if performed by an untrained physician?” A five-point Likert scale ranging from 1 “Strongly disagree” to 5 “Strongly agree” was used. Feasibility covered suitability for simulationbased training, availability of equipment, and associated costs. The simulation steering committee was tasked to explore feasibility
Index for simulation-based training of a given procedure N-proc+N-dr+Impact+Feasibility N-proc: the number of procedures performed annually in Denmark, N-dr: the number of physicians that should be able to perform the procedure, Impact: High risk/discomfort=5; no risk= 1 Feasibility: suitability for simulation-based training + availability of equipment + costs
• Who do your group see as the learners for your procedure? • How can you identify them? • How can you reach them?
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INTRO
WHY?
HOW TO?
QUIZ TIME
• Determine the goals for your curriculum • Define your objectives?
DO WE NEED EVIDENCE?
1. Simulation-based training should replace the traditonal apprenticeship model for learning clinical skills. TRUE FALSE
2. Every hospital department with trainees should have virtual reality simulators and physical phantoms for simulation-based training.
3. The fidelity of the simulators is very important for the learning outcome. Higher realism equals better learning.
TRUE
TRUE
FALSE
FALSE
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4. Bootcamps (full-day hands-on courses) are very effective for learning technical skills.
5. A consultant needs to be present at all time during training to give instructions and offer feedback.
TRUE
TRUE
FALSE
FALSE
6. End-of-course exams are only necessary if required by the authorities – otherwise the time is better spent with extra training. TRUE FALSE
1. Simulation-based training should replace the traditonal apprenticeship model for learning clinical skills.
PRACTICE MAKES PERFECT
FALSE
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”I learned it after having destroyed as many eyes as i could fit in my hat”
38%
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2. Every hospital department with trainees should have virtual reality simulators and physical phantoms for simulation-based training.
FALSE
3. The fidelity of the simulators is very important for the learning outcome. Higher realism equals better learning.
FALSE
Equipment is not enough - Sorry
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4. Bootcamps (full-day hands-on courses) are very effective for learning technical skills.
FALSE
Distributed practice is better than massed practice
5. A consultant needs to be present at all time during training to give instructions and offer feedback.
FALSE
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Directed Self-Regulated Learning (DSRL)
6. End-of-course exams are only necessary if required by the authorities – otherwise the time is better spent with extra training.
FALSE
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Mastery learning
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THEORETICAL COURSE
EXAM
SIMULATION-BASED TRAINING
EXAM
SUPERVISED PRACTICE
EXAM
INDEPENDENT PRACTICE
MONITOR YOUR RESULTS
Conclusions
• Evidence-based Curriculum • • • •
Theory Simulation Supervised practice Independent practice
• Training • • • •
Centralized Learning Mastery Learning Distributed Learning Directed Self-regulated Learning
• Certification •
Assessment tools with evidence of validity
INTRO
WHY?
HOW TO?
QUIZ TIME
• Describe your course • Instructors, schedule, organization, equipment, etc.
DO WE NEED EVIDENCE?
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TAKE HOME MESSAGES • Trainees must practice before performing clinical procedures on patients • Equipment is just a (small) part of the puzzle • Space out the training • Allow trainees to find their own way and learn from mistakes • Train them AND test them!
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• Make a plan to secure the necessary resources • Describe possible barriers for the implementation of your curriculum
• Make an evaluation plan for your curriculum
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Professor Lars Konge, MD, PHD
[email protected]
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